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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
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Hyponatremic-hypertensive syndrome with extensive and reversible renal defects

Antonella Trivelli1, Gian Marco Ghiggeri, Alberto Canepa

  • 1Nephrology Unit, G. Gaslini Children's Hospital, Largo Gaslini 5, Genoa, Italy.

Pediatric Nephrology (Berlin, Germany)
|October 27, 2004
PubMed

Insights

Hyponatremic-hypertensive syndrome (HHS) in children with renal artery stenosis can cause severe hypertension and solute loss. Prompt blood pressure normalization is key, as HHS and tubulopathy can mask underlying renal artery stenosis.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research

Background:

  • Renal artery stenosis (RAS) in children can lead to severe hypertension.
  • Hyponatremic-hypertensive syndrome (HHS) is a rare complication associated with RAS.

Observation:

  • Two pediatric cases of RAS presenting with HHS, marked urine/solute loss, proteinuria, glycosuria, and hypercalciuria are detailed.
  • Proteinuria showed prompt remission post-blood pressure normalization, unlike other symptoms.

Findings:

  • HHS in pediatric RAS is linked to significant hyperfiltration-induced proteinuria and tubular dysfunction.
  • Acute hyponatremia and tubulopathy can obscure the diagnosis of underlying RAS.

Implications:

  • Recognizing HHS and associated tubular dysfunction is crucial for diagnosing RAS in children.
  • Early identification and management of RAS are vital to prevent long-term renal and cardiovascular complications.

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